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In my opinion, nursing philosophy has failed to provide a coherent ontological basis that truly directs nursing research and knowledge development. It’s not that everyone is wrong….it’s that while many scholars intuitively have identified anthropological factors as critical to understanding man’s responses to health/illness, we haven’t quite capitalized on the core issue of the most basic element common to all people: desires.

Desire is more basic than intention, choice, or action. Man always does what he most desires at any given moment, within the context of his circumstances. The contextual milieu is critical. If you miss this, you miss my point. I am not saying that man desires being in poverty or oppressed circumstances. Not at all….but every situation involves conscious desire even when only horrible choices exist. Even suicide is expression of the desire for contentment, of satisfaction, that unfortunately is seen as only existing by self-abolishment as a measure to relieve suffering.

The context limits the choices in good and bad ways both. But a person’s response to circumstances is always based on their strongest desire at the moment. To seek relief from suffering is another way of saying that people seek satisfaction, pleasure, and contentment and thus always act on their strongest desire at any given moment within the framework of their personal ethics and values.

Desire explains why some people choose healthy lifestyles and why others choose self-abusive habits. It is pleasure we all seek after. How that is satisfied depends on our ethics and values which are shaped by a myriad of factors.

Consider: the most consistent factor among centenarians (those who live 100+yrs.) is not healthy eating, exercise, and abstinence from all vices (however you want to define those). It is optimism, and a belief that “this, too, shall pass”.

Consider: Why don’t we discipline ourselves in healthy habits?
Could it be we have other desires that are more satisfying to us than good health?

Consider: How can we separate mind, heart, and body?
Answer: We can’t. And we need a nursing philosophy that bridges all three. That concept is desire. A second related element is relationship (but we’re not ready to discuss that yet).

So what satisfies you? What are your desires? These are very complex philosophical, ethical, and theological questions that must be considered in nursing philosophy. Research should target what influences individual human desires. It is the major determinant of people’s choices regardless of race, ethnicity, economic status, sex, religion, or educational level.

Nursing research should be focused at the level of human desire within individual and population contexts. If we can labor to understand what controls desires and help patients identify these, while finding ways to modify desires into those which result in wholeness of person, then we will surely be developing nursing knowledge to truly explain what nurses do in their holistic work to attain well-being within reality’s parameters. We will also then forge a road into a new realm of holistic nursing science in understanding how desires influence mind and body.I will be proposing a triperspectival model of ethic, existential factors, and situational factors to advance nursing knowledge. A model that will, with time and research, abolish the theory-practice gap. It is a model which I believe will have global significance as the concept of desire as basic to human nature is God-given to all men. As a fundamental ontology it is applicable to all cultures. More on that later.

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